Cryptococcosis, epileptic seizures and encephalopathy in a HIV-infected patient.
We report on a 32-year old HIV-infected male patient who was admitted to the hospital in a comatose state. A cryptococcus neoformans septicemia with meningoencephalitis was diagnosed. Intravenous treatment with amphotericin B was initiated and replaced three weeks later by fluconazole per os. With this therapy the patient recovered quite well. However, following two grand mal epileptic seizures he suddenly fell into a deep coma 22 days after admission to the hospital. The cause of the encephalopathy remained unclear, and the patient died 2 days later. Autopsy revealed a severe meningoencephalitis and a pneumonia due to cryptococcus neoformans. Departing from this case we discuss diagnosis, clinical presentation and treatment of cryptococcus meningoencephalitis.
Tolnay
M
M
Institut für Pathologie, Medizinische Universitätsklinik A, Basel.
Elzi
M
M
Reusser
P
P
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis*; D000284:Administration, Oral; D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D003455:Cryptococcus neoformans; D004830:Epilepsy, Tonic-Clonic / Q000209:etiology; D017809:Fatal Outcome; D015725:Fluconazole / Q000627:therapeutic use; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008590:Meningoencephalitis / Q000188:drug therapy / Q000209:etiology*; D018410:Pneumonia, Bacterial / Q000382:microbiology*; D018805:Sepsis / Q000382:microbiology*
D000666:Amphotericin B; D015725:Fluconazole
Kryptokokkose, epileptische Anfälle und Enzephalopathie bei einem Patienten mit HIV-Infektion.